Prenatal Imaging for Cleft Lip and Palate.

Cleft lip (CL) and cleft palate (CP) are common orbitofacial birth defects that vary in severity and effect on anatomical function. They might occur as an isolated event, be associated with a syndrome, or result from genetic and environmental factors. Diagnosis and treatment of individuals begin prenatally and can extend through adulthood. Sonography and magnetic resonance imaging are used prenatally to evaluate and monitor treatment outcomes and complications associated with CL and CP. This article discusses the anatomical development of CL and CP and the imaging techniques used to diagnose and manage them.

Imaging and Diagnosis of Physical Child Abuse.

Child abuse involves grave and disturbing acts of violence that can have lasting physical and emotional consequences for children and their families. The diagnosis of child abuse is emotionally difficult for those involved, and an error in judgment either way can have a detrimental effect on the health and safety of the child. Physicians rely on the skills of the imaging team to produce high-quality images that assist in differentiating inflicted injuries from accidental trauma. This article explores the significance of imaging in child abuse by discussing the types of injuries that occur and the imaging studies that aid in diagnosing physical child abuse.

Full-Field Digital Mammography and Digital Breast Tomosynthesis.

Innovation in breast imaging techniques is leading to better breast cancer detection. Concurrently, breast cancer screening recommendations are changing, and breast density is becoming a more significant factor in breast cancer screening. Digital mammography has become the preferred screening method, with more breast imaging centers including the use of digital breast tomosynthesis (DBT). The technology's role in breast imaging has not been clarified fully, and several clinical trials are addressing DBT. This article presents research findings on digital mammography and DBT and explores the future role of 3-D breast imaging.

Radiation protection education in fluoroscopy.

Potential biological damage from radiation received during fluoroscopy procedures is of particular concern because of the high volume and variety of procedures performed and the increasing length of radiation exposure. This article focuses on the effects of low-level radiation, gaps in education and skills among personnel performing and assisting with fluoroscopy, the certification and privileging of fluoroscopy personnel, and compliance with radiation protection practices.

Breast implants: history, safety, and imaging.

Breast implants are classified as medical devices because they are used to correct the size or shape of a woman's natural breast or to create a new breast after mastectomy. Breast augmentation is the most popular cosmetic surgery performed in the United States today. Over the decades, breast implants have been constructed using different types of materials, including sponges, silicone, and saline. Each type of implant has advantages and disadvantages, and all pose a challenge in breast imaging. Breast implant rupture is common and has hidden characteristics that pose challenges for radiologic technologists and physicians. This article provides detailed information on breast reconstruction, implant safety, imaging techniques, and the latest implant materials.

Stroke and CT Perfusion.

Stroke is one of the leading causes of long-term disability and the fourth leading cause of death in the United States, killing more than 137,000 people a year. Time is critical during a stroke because prompt diagnosis and subsequent treatment can prevent the potential loss of brain function. Radiologic technologists who work in computed tomography (CT) must know how to perform CT perfusion and understand stroke diagnosis. This article provides information regarding strokes and CT perfusion techniques, including data acquisition, postprocessing, and interpretation.

Breast magnetic resonance imaging.

Mammography has long been considered the gold standard for screening breast cancer. Although it reduces the risk of breast cancer mortality by enabling early diagnosis, it does not detect all breast cancers. Numerous breast imaging technologies are emerging as effective adjunctive diagnostic tools when mammography results are negative or inconclusive. Contrast-enhanced magnetic resonance (CE-MR) imaging, in particular, has demonstrated a high sensitivity and has proven to be most effective, especially with patients at high risk for developing breast cancer. This article discusses the clinical applications for breast MR imaging, use of CE-MR for breast cancer detection, and other emerging breast imaging technologies.

Massive clonidine overdose during refill of an implanted drug delivery device for intrathecal analgesia: a review of inadvertent soft-tissue injection during implantable drug delivery device refills and its management.

OBJECTIVES: The study aims to highlight the potentially serious consequences of inadvertent soft-tissue injection of intrathecal drugs such as clonidine, during refills of implanted drug delivery devices, and to suggest strategies to reduce this complication. DESIGN: Case report and literature review were used. RESULTS: We report the case of a 51-year-old female with chronic arm pain who sustained a massive clonidine overdose (18,000 mcg) due to inadvertent soft-tissue injection during a refill of an implanted drug delivery device, resulting in rapid loss of consciousness and significant cardiovascular instability requiring urgent resuscitation, subsequent myocardial infarction, cardiac failure, and other significant complications. The risks of inadvertent soft-tissue injection of intrathecal drugs during implanted drug delivery device refills and management of such events is poorly documented in the literature. CONCLUSION: Inadvertent soft-tissue injection is possibly an underappreciated and underreported complication of intrathecal analgesia via an implanted drug delivery device. Under some circumstances, large doses of other intrathecal drugs such as bupivacaine, opioids, ziconotide, and baclofen may also be delivered by inadvertent soft-tissue injection with potentially life-threatening consequences. We recommend that practitioners, institutions, and professional bodies who manage patients with intrathecal analgesia via intrathecal drug delivery devices highlight and audit this complication and develop systems to manage it.

Genetics and genomic medicine.

Genetics is playing an increasingly important role in the diagnosis, monitoring and treatment of diseases, and the expansion of genetics into health care has generated the field of genomic medicine. Health care delivery is shifting away from general diagnostic evaluation toward a generation of therapeutics based on a patient's genetic makeup. Meanwhile, the scientific community debates how best to incorporate genetics and genomic medicine into practice. While obstacles remain, the ultimate goal is to use information generated from the study of human genetics to improve disease treatment, cure and prevention. As the use of genetics in medical diagnosis and treatment increases, health care workers will require an understanding of genetics and genomic medicine.

How the EHR transforms the HIM department: two stories. Document imaging, workflow restructure department.

HIM professionals have long known the electronic health record (EHR) will change the collection, storage, and maintenance of health information, not to mention the delivery of care, but what about the its effects on the HIM department? While revolutionizing the HIM process, there can't help but be major changes in the job descriptions, leadership, and even the physical layout of the department. In this article, learn how the implementation of the EHR transformed two HIM departments--for the better.